1983, 09-20 Permit: 83A-9243 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY 8 - q �
C1 NORTH 811 JEFFERSON /SPOKANE,WAS-INGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS `le PARCEL NO.
` �j
LOT BLOCK SUBDIVISION/ LEGAL DESCRIPTION: `
2.
OWNER // f� PHONE PHONE
3 MAILING ADDREE S" / ZIP Actual Set Backs in Feet to:
North !South [East I West
CONTRACTOR ,/ LICENSE EXPIRES PHONE_ Size of Parcel [East
Classification Residential❑
4. i`' -ed/iw, d"(77 7.C.7 Commercial❑
ADDRESS 6/6.WI— ,_,`.,, ZIP Type Const. Occupancy Sprinklered
y" CCf��9r ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5.
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF
❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. CIM.H. El POOL Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes No❑
DESCRIBE W(] J Shorelines/Flood Hazard Plans Required❑
8 fir/ � � �,��" /,ill Yes❑ Not Applic.❑ Received ❑
VALUATION tOOFURCE GAS ELECTRIC WAPUBTER
O SEW SEPTIC Ownership FEES COLLECTED
9 UTILITIES PRIVATE❑ SEWER❑ Public❑Private❑
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of Building
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction.SEE REVERSE DE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF / APPLICATION ,7
i 6,-)Mech. 4.C�`
OWNER OR AGENT /C��= "� ��.- DATE 2
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home ..
Prevent. d
O
Engineer
Other(Specify) V
W
_1
Utilities LL•
TOTAL $ (ct'oz,.
SEPA
MACHINE
Plans PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERM TTED IN THIS SPACE,
Exam. / PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED ((�� 9
Tech.Building `/x, IN 180 DAYS DATE 15S 9ED 2 0 _8 PERMIT NO 4' z *
9, 0
0
TOTAL